This invention relates to surgical retractors and methods for their use, and particularly to retractors for use in retracting the gallbladder and other organs during laparoscopic procedures, such as laparoscopic cholecystectomy, and methods for their use.
Laparoscopic procedures are often used for performing surgical operations within the abdomen of a patient to minimize the invasion of and trauma to the patient. One such operation is a cholecystectomy, wherein a gallbladder which contains stones or is otherwise diseased is resected. In laparoscopic cholecystectomy the peritoneal cavity is entered just below the umbilicus with an insufflating needle and a pneumoperitoneum is created. At the same site, a port, consisting of a trocar sheath or introducer with a valve to prevent air loss, is introduced into the peritoneal cavity by a trocar. A viewing telescope, typically including a video camera, is inserted through the trocar sheath to inspect the peritoneal cavity. In addition, two lateral ports and one upper midline port are introduced. Typically, the two lateral ports are used for grasping the gallbladder with atraumatic clamps and retracting it to bring its lower end into view. The upper midline port is used for dissection.
In the typical operation, the cystic duct is located, clipped proximally and distally, and divided. The cystic artery is also located, clipped proximally and distally, and divided. The gallbladder is then removed from the gallbladder bed. The telescope is moved to the upper midline port and the gallbladder is grasped using an instrument with a toothed tip inserted through the umbilical port. Then, the gallbladder is drawn into the umbilical trocar sheath and the trocar sheath is drawn out of the peritoneal cavity, pulling the gallbladder out with it.
A significant problem with this procedure is that a diseased or "hot" gallbladder is ordinarily very hard and difficult to grasp with conventional instruments. Clamps tend to slip off the gallbladder, and if adequate pressure is applied to grasp the gallbladder, the clamps tend to puncture it. In the former case, the completion of the operation is hampered and in the latter case, infection may result. A similar problem occurs in the retraction of other organs, such as a diseased ovary, during other laparoscopic procedures.
Accordingly, there is a need for an improved retractor and method for use thereof in laparoscopic procedures.